1 Department of Pediatrics and Division of Child Psychiatry at Albert Einstein College of Medicine-Bronx Municipal Hospital Center, New York City
A complex case of chronic tongue biting in a mentally retarded, adolescent hemophiliac is presented to demonstrate principles of comprehensive care. Problems arising out of (1) the psychosocial status of the child and parents, (2) psychodynamics of individual physicians, and (3) group dynamics of the medical team are described. Specific countermeasures are spelled out. Particular attention is given to the problems faced by clinic and ward pediatrics in dealing with chronic, life-threatening illness when continuous monitoring of psychogenic factors is essential to appropriate management.
Submitted on November 8, 1967